Leah Moncrieff, Morgan O'Reilly, Leanne Hall, Clare Heal
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引用次数: 0
摘要
梅毒仍然是一个紧迫的公共卫生问题,如果不及时治疗,可能会导致严重的发病率。要改善梅毒筛查,有针对性的干预措施至关重要,尤其是在高危人群中。本系统性综述综合比较了在有干预措施和没有干预措施的情况下进行梅毒筛查的研究。我们对四个数据库(Medline、Embase、Cinahl 和 Scopus)进行了系统检索。评估的主要结果包括梅毒筛查、再筛查和检出率。对研究结果进行了叙述性综合。如果多项研究在临床方面存在差异,则计算汇总的几率。共纳入 24 项研究。各种干预措施都显示出了良好的前景,包括临床医生提醒可提高梅毒筛查率(OR 范围为 1.25-1.45),患者短信提醒可提高复筛/复诊率(OR 范围为 0.93-4.4)。将梅毒血清学检测与 HIV 常规监测相结合,可提高接受这两项检测的 HIV 阳性者的比例。然而,以梅毒检出率为结果对三项有关该干预措施的研究进行汇总,结果并不确定(汇总 OR 1.722 [95% CI 0.721-2.723],I 2 =24.8%,P =0.264)。鉴于医院并非公共卫生活动的典型场所,因此引入医院打包检测来筛查高危人群的做法非常独特。护士主导的诊所和临床医生激励措施都是成功的策略。将梅毒筛查与其他现有项目结合起来有可能提高筛查率(OR 范围为 1.06-2.08),但还需要进一步调查。技术驱动的干预措施产生了具有成本效益、可行且积极的结果。在实现指南推荐的男男性行为者筛查频率方面存在明显挑战,这表明需要采取多方面的方法。更广泛地应用这些干预措施可提高梅毒筛查率和检出率。
Interventions aimed at increasing syphilis screening among non-pregnant individuals in healthcare settings: a systematic review and meta-analysis.
Syphilis remains a pressing public health concern with potential severe morbidity if left untreated. To improve syphilis screening, targeted interventions are crucial, especially in at-risk populations. This systematic review synthesises studies that compare syphilis screening in the presence and absence of an intervention. A systematic search of four databases was conducted (Medline, Embase, Cinahl and Scopus). The primary outcomes evaluated included syphilis screening, re-screening and detection rates. Findings were synthesised narratively. Where multiple studies were clinically heterogenous, a pooled odds ratio was calculated. Twenty-four studies were included. A variety of interventions showed promise including clinician alerts, which increased syphilis screening rate (OR range, 1.25-1.45) and patient SMS reminders that mostly improved re-screening/re-attendance rates (OR range, 0.93-4.4). Coupling syphilis serology with routine HIV monitoring increased the proportion of HIV-positive individuals undergoing both tests. However, pooling three studies with this intervention using the outcome of syphilis detection rate yielded inconclusive results (pooled OR 1.722 [95% CI 0.721-2.723], I 2 =24.8%, P =0.264). The introduction of hospital-based packaged testing for screening high-risk individuals is unique given hospitals are not typical locations for public health initiatives. Nurse-led clinics and clinician incentives were successful strategies. Including syphilis screening with other existing programs has potential to increase screening rates (OR range, 1.06-2.08), but requires further investigation. Technology-driven interventions produced cost-effective, feasible and positive outcomes. Challenges were evident in achieving guideline-recommended screening frequencies for men who have sex with men, indicating the need for multifaceted approaches. Wider application of these interventions may improve syphilis screening and detection rates.
期刊介绍:
Sexual Health publishes original and significant contributions to the fields of sexual health including HIV/AIDS, Sexually transmissible infections, issues of sexuality and relevant areas of reproductive health. This journal is directed towards those working in sexual health as clinicians, public health practitioners, researchers in behavioural, clinical, laboratory, public health or social, sciences. The journal publishes peer reviewed original research, editorials, review articles, topical debates, case reports and critical correspondence.
Officially sponsored by:
The Australasian Chapter of Sexual Health Medicine of RACP
Sexual Health Society of Queensland
Sexual Health is the official journal of the International Union against Sexually Transmitted Infections (IUSTI), Asia-Pacific, and the Asia-Oceania Federation of Sexology.